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Maine rates for HCPCS J0740

Injection, cidofovir, 375 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,267.39 / $1,267.39 / $1,365.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$568.15 / $606.92 / $750.22
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$528.64 / $663.58 / $1,731.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $546.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$546.29 / $546.29 / $546.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $546.29
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $661.56
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,267.39 / $1,267.39 / $1,365.72
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$551.75 / $606.92 / $750.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $956.01